Back lesions may be seen late

This is late stage localised morphoea or scleroderma. In the early stage there is a violaceous discolouration of the skin which then develops a white or pale centre as excess collagen is laid down in the dermis. Later on, the violaceous colour disappears and the white colour is predominant. Later still, a type of post inflammatory pigmentation appears and ultimately the lesion softens up and pigments all over as the collagen disappears.

Some patients may present at this late stage not having been aware of what has gone on before. There is no effective treatment for localised scleroderma.